Combined pills (Combined oral contraceptive pills)
Combined contraceptive pills, the most commonly prescribed pill, contain two versions of naturally occurring female hormones - oestrogen and progesterone. There are also different versions of these synthetic hormones, which surround generational pill changes over the years, and some affect women in different ways.
Each month, levels of oestrogen and progesterone rise and fall naturally which impacts how and when the female body prepares for pregnancy. Ovulation occurs, for example, and the uterus lining thickens to create a safe environment to receive a fertilised egg.
When you take combined contraceptive pills, natural levels of these hormones are altered. In doing so, the way in which the body prepares for pregnancy changes. Eggs don’t get released, vaginal mucus thickens which makes it difficult for sperm to pass through the cervix and the uterus lining remains thin - meaning in the (now very unlikely) event an egg does get fertilised, it will have a tricky time implanting itself in the uterus where it would normally grow.
Typically, you take the combined pill for 21 days followed by a seven day break, although it is possible to take the combined pill without any breaks. Sometimes, you won’t take any pills during your break, or some pill packets will contain inactive pills that are included to help you maintain a routine. Certain other combined contraceptive pills are taken for 24 days, followed by only four days of taking placebo pills.
Combined pills are over 99% effective when used perfectly. (Perfectly meaning you never forget to take a pill and always take them at the time you’re supposed to.)
Common side effects associated with the combined pill can include feeling sick, stomach ache, putting on weight, headaches, depressive moods or mood swings and sore or painful breasts. However, because certain combined pill brands contain different versions of female hormones, depending on their generation, switching pills can sometimes help reduce certain side effects.
Pros and cons of the combined pill
Advantages of the combined pill:
- You’re in control, you can start and stop using the method whenever it suits you
- Won’t interrupt sex in the same way a condom might
- Can make periods more regular, lighter or less painful
- Reduces the risk of certain types of cancer, including of the womb and ovaries
- Can reduce premenstrual symptoms
- Can reduce acne
- May reduce the chance of pelvic inflammatory disease
- May reduce the risk of ovarian cysts and fibroids
Disadvantages of the combined pill:
- May cause side effects that clear up over time, including headaches, feeling sick, tender breasts and mood swings.
- May increase blood pressure for some women
- Doesn’t protect against STIs
- Spotting is common for the first few months of using the pill
- Has been linked with a small but increased risk of blood clots and breast cancer.